The Haven Of Paris

observation of resident having ahold of another female (R6) by both wrists and that per protocol was

to visit today due to the inclement weather but plans to come tomorrow. HPOA has no concerns or

the right of our residents to be free from abuse, neglect, misappropriation of resident property, and exploitation, which includes, but is not limited to, freedom from corporal punishment, involuntary seclusion and any physical or chemical restraint not required to treat the resident's medical symptoms.

This facility therefore prohibits mistreatment, exploitation, neglect or abuse of its residents, and has attempted to establish a resident sensitive and resident secure environment.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

of nine residents (R3 -R7) reviewed for abuse on the sample list of 18.

Findings include:1. R'4s/R3's

R4's face, and the Ombudsman was notified, as the facility abuse prevention policy directs.2. R4/R5 IDPH resident to resident physical abuse investigation report dated 6/21/25 documents R4 swatted R5's back, and the Ombudsman was notified, as the facility abuse prevention policy directs. 3. R4/R6 IDPH resident to resident physical abuse investigation report dated 6/18//25 documents R4 grabbed R6's wrist, and the Ombudsman was notified, as the facility abuse prevention policy directs. 4. R7's IDPH report dated 8/19/25 documents R7 was handling rough by an unidentified nursing staff named ( V11, Nursing staff) causing a bruise to R7's arm, and the Ombudsman was notified, as the facility abuse prevention policy directs.

All of the above reports were documented by V1, Administrator/ Abuse Prevention Coordinator.

Each of the above reports document that the Ombudsman was notified of the alleged abuse.On 8/21/25 at 11:13 AM V20, Ombudsman discussed the the above alleged abuse investigation reports with the corresponding dates. V20 said V20 reviewed all V20's correspondence with the facility over this time frame and associated dates. V20, Ombudsman stated he was not notified by the facility of any of the above allegations. V20, said V20 reviewed his notes, emails and phone calls. V20 also stated he was in the facility last week and was present during the facility Resident Council Group meeting. V20 stated the facility did not notify V20 in person, of any of the abuse/injury of unknown allegations documented above.The facility Abuse Policy dated as revised 01/09/24 documents, The Facility will report all allegations of abuse immediately to the Administrator and timely to the proper authorities to include IDPH ( Illinois Department of Public Health), Ombudsman, Local P.D (Police Department), POA ( residents Power of Attorney), and M.D. (Physician) in a timely manner.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

authorities.

physical abuse, staff to resident physical abuse, and injuries of unknown origin to the police

residents (R3-R7) reviewed for abuse on the sample list of 18.Findings include: 1. R'4s/R3's IDPH resident to resident physical abuse investigation report dated 7/5/25 documents R3 smacked R4's face, and the local police department and physician were notified. 2. R4/R5 IDPH resident to resident physical abuse investigation report dated 6/21/25 documents R4 swatted R5's back, and the local police department and physician were notified. 3. R4/R6 IDPH resident to resident physical abuse investigation report dated 6/18//25 documents R4 grabbed R6's wrist, and the local police department and physician were notified. 4. R7's IDPH report dated 8/19/25 documents R7 was handling rough by an unidentified nursing staff causing a bruise to R7's arm, and the local police department and physician were notified.

All of the above reports were documented by V1, Administrator/ Abuse Prevention Coordinator.

Each of the above reports document that the local police department and the physician were notified, as the facility abuse prevention policy directs.On 8/21/25 at 10:20 AM, V19, Supervisor, Local Police Department stated the police department has no records, reports or dispatch calls of the facility contacting them regarding any of the above report.On 8/22/25 at 1:10 PM, V3, Medical Director/Physician (MD) reviewed V3, MD's records, facsimiles and phone calls on each of the above allegations of abuse. V3 said had not been notified of any of the above allegations. V3,MD also said that on-call physicians report all events in the facility to V3, MD.

V3 said he does not see any evidence from the on-call providers that reflects they were notified of the above abuse investigations.On 8/22/25 at 12:40 pm V1 Administrator/Abuse Prevention Coordinator stated I called the police, and they asked if I wanted them to come out and I said no. I have nothing to show that I called and I don't keep my phone calls on my cell phone. I have no proof. I will have to get proof from now on. I will get a name or report number from the Police. V1 also stated As far as family and the physician, the nurses should be documenting accurately if they aren't getting a hold of a family and the doctor.

That is what I go by in my investigation. I know I talked to (V23 Power of Attorney/R6's Family) about other things.

The nurses are to report to the families about any resident-to-resident altercation. I guess I can't prove that either.The facility Abuse Policy dated as revised 01/09/24 documents the following: investigation has been complete.

The Facility will report all allegations of abuse immediately to the Administrator and timely to the proper authorities to include IDPH ( Illinois Department of Public Health), Ombudsman, Local P.D (Police Department), POA ( residents Power of Attorney), and M.D. (Physician) in a timely manner.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

facility, that may have knowledge of alleged abuse.

This failure had the potential to affect five of nine

resident to resident physical abuse investigation report dated 7/5/25 documents R3 smacked R4's face.

The facility investigation determined this allegation to be unfounded, though no families or other residents were interviewed. 2. R4/R5 IDPH resident to resident physical abuse investigation report dated 6/21/25 documents R4 swatted R5's back.

The facility investigation determined this allegation to be unfounded, though no families or other residents were interviewed. 3. R4/R6 IDPH resident to resident physical abuse investigation report dated 6/18//25 documents R4 grabbed R6's wrist.

The facility investigation determined this allegation to be unfounded, though no families or other residents were interviewed. 4. R7's IDPH report dated 8/19/25 documents R7 was handling rough by an unidentified nursing staff causing a bruise to R7's arm.

The facility investigation determined this allegation to be unfounded, though no families or other residents were interviewed. On 8/22/25 at 8:40 am V1, Administrator confirmed the abuse investigation ( R3-R7) provided throughout the survey (8/19/25 - 8/22/25) are complete. V1 then confirmed she did not interview families that visit the facility frequently, or other residents who may have knowledge of alleged abuse incidents.

The facility's Abuse Policy dated as revised 01/09/24 documents the following, The facility immediately and thoroughly investigates all allegations of abuse to include but not limited to interviews of residents and staff, visitors, vendors.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

property and mistreatment, and making the necessary changes to prevent future occurrences.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

nurses on a full time basis.

nurses to oversee and coordinate nursing services provided within the facility.

This failure has the

through 8/22/25 there was no Director of Nursing (DON) in the building.On 8/19/25 at 10:10 am V1, Administrator/Abuse Prevention Coordinator stated V2, previous Director of Nursing's last day employed for the facility was Friday 8/15/25. V1 stated she has not hired a Registered Nurse for the DON position, nor does the facility have an Acting DON to provide oversite of the nursing services.The facility resident roster dated 8/19/25 documents 83 residents reside in the facility.

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The Haven of Paris 1011 North Main Street Paris, IL 61944

in accordance with accepted professional standards.

medical records for one of nine residents ( R6) reviewed for abuse/injury of unknown origin on the

Follow-Up. notes dated 2/20/25, 4/10/25, 4/17/25, 6/19/25 and 7/10/25 document R6 was assessed by V3, Medical Director (Physician).

These notes were signed by V3, Medical Director. V3, MD documented R6 'Integumentary (skin)' assessments indicates R6 had left cheek and left, lower rib cage bruises on each of these assessment. On 8/22/25 at 1:10 PM V3, Medical Director reviewed R6's medical record documentation and said he now recognized his documentation was not accurate in V3, MD Nursing home visit notes that he documented on 2/20/25, 4/10/25, 4/17/25, 6/19/25 and 7/10/25. V3 confirmed R6 had a fall in December 2024 and continued with bruises in January but did not have bruising on the above mentioned dates. V3, MD acknowledged this was a documentation error. V3, MD also said V3, MD will add an addendum to each of those progress notes.R6's revised Progress notes dated 2/20/25, 4/10/25, 4/17/25, 6/19/25 and 7/10/25 have the following addendum signed by V3, MD: C: PHC NH (Point Click Care Nursing Home) Addendum: Integumentary: Bruising noted to left cheek and left lower ribs was added to chart due to documentation error. ZOO.DO: Encounter for general adult medical examination without abnormal findings.